WO2013129450A1 - 治療計画装置及び治療計画方法並びにそのプログラム - Google Patents

治療計画装置及び治療計画方法並びにそのプログラム Download PDF

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Publication number
WO2013129450A1
WO2013129450A1 PCT/JP2013/055076 JP2013055076W WO2013129450A1 WO 2013129450 A1 WO2013129450 A1 WO 2013129450A1 JP 2013055076 W JP2013055076 W JP 2013055076W WO 2013129450 A1 WO2013129450 A1 WO 2013129450A1
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WIPO (PCT)
Prior art keywords
specific part
position information
range
representative
calculation unit
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PCT/JP2013/055076
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English (en)
French (fr)
Japanese (ja)
Inventor
保恒 鈴木
平岡　真寛
幸憲 松尾
Original Assignee
三菱重工業株式会社
国立大学法人京都大学
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Application filed by 三菱重工業株式会社, 国立大学法人京都大学 filed Critical 三菱重工業株式会社
Priority to US14/379,906 priority Critical patent/US9393444B2/en
Priority to CN201380010659.9A priority patent/CN104136080B/zh
Priority to EP13754047.2A priority patent/EP2821100B1/de
Publication of WO2013129450A1 publication Critical patent/WO2013129450A1/ja

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A61N5/1037—Treatment planning systems taking into account the movement of the target, e.g. 4D-image based planning
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A61N5/1031—Treatment planning systems using a specific method of dose optimization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/103—Treatment planning systems
    • A61N5/1039—Treatment planning systems using functional images, e.g. PET or MRI
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1049—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam
    • A61N2005/1061—Monitoring, verifying, controlling systems and methods for verifying the position of the patient with respect to the radiation beam using an x-ray imaging system having a separate imaging source
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1048—Monitoring, verifying, controlling systems and methods
    • A61N5/1064—Monitoring, verifying, controlling systems and methods for adjusting radiation treatment in response to monitoring
    • A61N5/1065—Beam adjustment
    • A61N5/1067—Beam adjustment in real time, i.e. during treatment
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1077—Beam delivery systems
    • A61N5/1081—Rotating beam systems with a specific mechanical construction, e.g. gantries
    • A61N5/1082—Rotating beam systems with a specific mechanical construction, e.g. gantries having multiple beam rotation axes

Definitions

  • the present invention relates to a treatment planning apparatus, a treatment planning method, and a program thereof that specify the position of a specific part in a subject and calculate the radiation dose irradiated to the specific part.
  • Radiotherapy is known in which radiation is applied to an affected area, which is a specific site within a subject. In this radiotherapy, it is necessary to determine the dose of radiation and the position of the radiation source that are applied to a specific site (affected area) using a treatment planning device.
  • Patent Document 1 discloses a technique for estimating the position of an affected area from a relative position with respect to the position.
  • Patent Document 2 discloses a technique for calculating the radiation dose irradiated to a specific part.
  • some aspects of the present invention provide a treatment planning apparatus, a treatment planning method, and a program thereof that can measure the radiation dose of a specific part that moves or changes in range within a subject with time. It is an object.
  • a treatment planning apparatus that specifies a position of a specific part in a subject and calculates a radiation dose irradiated to the specific part is in the vicinity of the specific part.
  • a specific part position calculation unit that calculates position information of the specific part for a plurality of times according to the passage of time based on the positions of a plurality of markers located at the position, and a three-dimensional range of the specific part is generated for each of the plurality of times
  • the specific part range information generation unit to perform and a range including all the three-dimensional ranges of the specific part for each of the plurality of times when the position information of the specific part for each of the plurality of times is set as the same reference point
  • the representative region representative range information generating unit that generates representative range information, and the representative range information indicates the position information of the specific region for the plurality of times.
  • Serial and a radiation amount calculation unit that calculates the amount of radiation in the range of the specific portion of the shown typical range information when the radiation in the range of the
  • the specific part position calculation unit acquires reference position information indicating a position in the subject at a reference time of each of the specific part and the plurality of markers.
  • a relative position information calculation unit that generates relative position information based on the position indicated by the reference position information of the representative point at the position indicated by the reference position information of the specific part, and at another time different from the reference time
  • a marker position information acquisition unit that acquires position information of the plurality of markers in the subject and position information of the plurality of markers at the other time of the plurality of markers. From the representative point position information calculation unit that generates position information of the representative point in the subject, the position information of the representative point, and the relative position information, position information of the specific part at the other time is generated.
  • a specific part position information calculation unit is generated from the representative point position information calculation unit that
  • the representative point reference position information calculation unit specifies a weighting factor for each of the plurality of markers, and the plurality of markers weighted by the weighting factor. Based on the position information, reference position information of the representative point is generated, and the representative point position information calculation unit generates position information of the representative point based on the position information of the plurality of markers weighted by the weighting factor.
  • a treatment planning method of a treatment planning apparatus for identifying a position of a specific part in a subject and calculating a radiation dose irradiated to the specific part includes a specific part position calculating unit, Based on the positions of a plurality of markers located in the vicinity of the specific part, the position information of the specific part for a plurality of times according to the passage of time is calculated, and the specific part range information generation unit is configured to generate a three-dimensional range of the specific part. Is generated for each of the plurality of times, and the specific part representative range information generation unit uses the position information of the specific part for each of the plurality of times as the same reference point.
  • Representative range information indicating a range including all three-dimensional ranges is generated, and the radiation dose calculation unit follows the positional information of the specific part for the plurality of times, and Information said calculating the amount of radiation in the range of the specific portion of the shown typical range information when the radiation in the range of the specific portion was irradiated predetermined time indicated.
  • a program for executing a computer of a treatment planning apparatus that specifies a position of a specific site in a subject and calculates a radiation dose to be irradiated to the specific site is stored in the specific site.
  • Specific part position calculating means for calculating position information of the specific part for a plurality of times according to the passage of time based on the positions of a plurality of markers located in the vicinity, and generating a three-dimensional range of the specific part for each of the plurality of times
  • a specific part range information generating means for representing a range including all the three-dimensional ranges of the specific part for each of the plurality of times when the position information of the specific part for each of the plurality of times is the same reference point
  • Specific part representative range information generating means for generating range information, following the position information of the specific part for the plurality of times, Radiation amount calculating means for calculating the amount of radiation in the range of the specific portion indicated by the typical range information when the radiation is irradiated for a predetermined time in the range of the specific portion indicated by the typical range information, to function as a.
  • the present invention it is possible to calculate the radiation dose more accurately when the irradiation range is set so that the irradiation leakage to the specific part does not occur.
  • FIG. 2 is a functional block diagram of a treatment planning device 1.
  • FIG. 3 is a functional block diagram of a specific part position calculation unit 130.
  • FIG. 6 is a first diagram illustrating a flowchart of processing of a specific part position calculation unit. It is a 2nd figure which shows the flowchart of a process of the specific site
  • FIG. 10 is a third diagram illustrating a flowchart of the process of the specific part position calculation unit 130.
  • FIG. 1 It is a figure explaining an example of the calculation method of a relative parameter. It is a figure which shows the correspondence of the displacement amount from the reference position of a specific part, and the displacement amount from the reference position of a marker. It is a figure which shows the process outline
  • FIG. 1 It is a figure explaining an example of the calculation method of a relative parameter. It is a figure which shows the correspondence of the displacement amount from the reference position of a specific part, and the displacement amount from the reference position of a marker. It is a figure which shows the process outline
  • FIG. 1 is a diagram showing a radiotherapy system including a treatment planning apparatus according to the embodiment.
  • symbol 1 has shown the treatment planning apparatus.
  • Reference numeral 2 denotes a radiotherapy apparatus control apparatus, and reference numeral 3 denotes a radiotherapy apparatus.
  • the treatment planning device 1 and the radiation treatment device control device 2 are connected by communication.
  • the radiotherapy device control device 2 and the radiotherapy device 3 are communicatively connected.
  • the treatment planning apparatus 1 is an apparatus for determining position information of a specific part such as an affected part existing in a subject such as a human or calculating a radiation dose.
  • the radiotherapy device control device 2 is a device that controls the radiotherapy device based on the plan information generated by the treatment plan device 1.
  • the radiotherapy apparatus 3 is an apparatus that irradiates radiation so as to pass a position indicated by position information of a specific part based on an instruction from the radiotherapy apparatus control apparatus 2.
  • FIG. 2 is a view showing the radiation therapy apparatus 3.
  • the radiotherapy device 3 includes a turning drive device 11, an O-ring 12, a traveling gantry 14, a swing mechanism 15, and a therapeutic radiation irradiation device 16.
  • the turning drive device 11 supports the O-ring 12 on the base so as to be rotatable about the rotation shaft 17, and is rotated by the radiotherapy device control device 2 to rotate the O-ring 12 about the rotation shaft 17.
  • the rotating shaft 17 is parallel to the vertical direction.
  • the O-ring 12 is formed in a ring shape with the rotation shaft 18 as a center, and supports the traveling gantry 14 so as to be rotatable about the rotation shaft 18.
  • the rotating shaft 18 is perpendicular to the vertical direction and passes through an isocenter 19 included in the rotating shaft 17.
  • the rotating shaft 18 is further fixed to the O-ring 12, that is, rotates around the rotating shaft 17 together with the O-ring 12.
  • the traveling gantry 14 is formed in a ring shape centered on the rotation shaft 18, and is disposed so as to be concentric with the ring of the O-ring 12.
  • the radiation therapy apparatus 3 further includes a travel drive device (not shown). The travel drive device is controlled by the radiotherapy device control device 2 to rotate the travel gantry 14 around the rotation shaft 18.
  • the swing mechanism 15 is fixed to the inside of the ring of the traveling gantry 14 and supports the therapeutic radiation irradiation device 16 on the traveling gantry 14 so that the therapeutic radiation irradiation device 16 is disposed inside the traveling gantry 14. Yes.
  • the head swing mechanism 15 has a pan axis 21 and a tilt axis 22.
  • the tilt shaft 22 is fixed to the traveling gantry 14 and is parallel to the rotation axis 18 without intersecting the rotation axis 18.
  • the pan axis 21 is orthogonal to the tilt axis 22.
  • the head swing mechanism 15 is controlled by the radiation therapy apparatus control apparatus 2 to rotate the treatment radiation irradiation apparatus 16 about the pan axis 21 and rotate the treatment radiation irradiation apparatus 16 about the tilt axis 22.
  • the therapeutic radiation irradiation device 16 is controlled by the radiotherapy device control device 2 to emit the therapeutic radiation 23.
  • the therapeutic radiation 23 is radiated substantially along a straight line passing through an intersection where the pan axis 21 and the tilt axis 22 intersect.
  • the therapeutic radiation 23 is formed to have a uniform intensity distribution.
  • the therapeutic radiation irradiation device 16 includes an MLC (multi-leaf collimator) 20.
  • the MLC 20 is controlled by the radiotherapy apparatus control apparatus 2 and changes the shape of the irradiation field when the patient is irradiated with the therapeutic radiation 23 by shielding a part of the therapeutic radiation 23.
  • the therapeutic radiation 23 is once adjusted so that the therapeutic radiation irradiation device 16 is directed to the isocenter 19 by the swing mechanism 15 by the therapeutic radiation irradiation device 16 being supported by the traveling gantry 14 in this manner. Even if the O-ring 12 is rotated by the turning drive device 11 or the traveling gantry 14 is rotated by the traveling drive device, the O-ring 12 always passes through the isocenter 19 at all times. That is, by running and / or turning, the therapeutic radiation 23 can be irradiated from any direction toward the isocenter 19.
  • the radiotherapy apparatus 3 further includes a plurality of imager systems. That is, the radiotherapy apparatus 3 includes diagnostic X-ray sources 24 and 25 and sensor arrays 32 and 33.
  • the diagnostic X-ray source 24 is supported by the traveling gantry 14.
  • the diagnostic X-ray source 24 is disposed inside the ring of the traveling gantry 14, and an angle formed by a line segment connecting the diagnostic X-ray source 24 from the isocenter 19 and a line segment connecting the therapeutic radiation irradiation device 16 from the isocenter 19. Is arranged at a position that makes an acute angle.
  • the diagnostic X-ray source 24 is controlled by the radiotherapy apparatus controller 2 and emits diagnostic X-rays 35 toward the isocenter 19.
  • the diagnostic X-ray 35 is a conical cone beam which is emitted from one point of the diagnostic X-ray source 24 and has the one point as a vertex.
  • the diagnostic X-ray source 25 is supported by the traveling gantry 14.
  • the diagnostic X-ray source 25 is disposed inside the ring of the traveling gantry 14, and an angle formed by a line segment connecting the diagnostic X-ray source 25 from the isocenter 19 and a line segment connecting the therapeutic radiation irradiation device 16 from the isocenter 19. Is arranged at a position that makes an acute angle.
  • the diagnostic X-ray source 25 is controlled by the radiotherapy apparatus controller 2 and emits diagnostic X-rays 36 toward the isocenter 19.
  • the diagnostic X-ray 36 is a cone-shaped cone beam emitted from one point of the diagnostic X-ray source 25 and having the one point as a vertex.
  • the sensor array 32 is supported by the traveling gantry 14.
  • the sensor array 32 receives the diagnostic X-ray 35 emitted from the diagnostic X-ray source 24 and transmitted through the subject around the isocenter 19 and generates a transmission image of the subject.
  • the sensor array 33 is supported by the traveling gantry 14.
  • the sensor array 33 receives the diagnostic X-ray 36 emitted from the diagnostic X-ray source 25 and transmitted through the subject around the isocenter 19 and generates a transmission image of the subject.
  • Examples of the sensor arrays 32 and 33 include FPD (Flat Panel Detector) and X-ray II (Image Intensifier).
  • the radiation therapy apparatus 3 further includes a sensor array 31.
  • the sensor array 31 is arranged so that a line segment connecting the sensor array 31 and the therapeutic radiation irradiation device 16 passes through the isocenter 19 and is fixed inside the ring of the traveling gantry 14.
  • the sensor array 31 receives the therapeutic radiation 23 emitted from the therapeutic radiation irradiation device 16 and transmitted through the subject around the isocenter 19, and generates a transmission image of the subject.
  • Examples of the sensor array 31 include FPD and X-ray II.
  • the radiation therapy apparatus 3 further includes a couch 41 and a couch driving device 42.
  • the couch 41 is used when a patient 43 to be treated by the radiation therapy system lies down.
  • the couch 41 includes a fixture not shown. The fixture secures the patient to the couch 41 so that the patient does not move.
  • the couch driving device 42 supports the couch 41 on the base and moves the couch 41 under the control of the radiation therapy device control device 2.
  • FIG. 3 is a diagram showing a patient (subject) 43.
  • the patient 43 has a specific part 61 inside the body.
  • the specific part 61 indicates an affected part of the patient 43 and is a part to which the therapeutic radiation 23 is to be irradiated.
  • As the specific part 61 a part of the lung is exemplified.
  • a plurality of markers 62 are arranged in the body of the patient 43.
  • the marker 62 is a minute metal piece embedded in the vicinity of the specific part 61 with the intention of staying at a predetermined position with respect to the specific part 61 in order to detect the position of the specific part 61, for example, using gold. It is done.
  • the marker 62 may be embedded by being injected into the subject from the needle of a syringe, or may be embedded by other methods such as surgery.
  • FIG. 4 is a functional block diagram of the treatment planning apparatus 1.
  • the treatment planning apparatus 1 includes a control unit 110, a communication unit 120, a specific site position calculation unit 130, a specific site range information generation unit 140, a specific site representative range information generation unit 150, and a radiation dose calculation unit 160.
  • Each processing unit and a storage unit 170 that stores information used for processing are provided.
  • the control unit 110 controls each processing unit.
  • the communication unit 120 is a processing unit that communicates with the radiotherapy device control apparatus 2.
  • the specific part position calculation unit 130 is a processing unit that calculates position information of a specific part for a plurality of times according to the passage of time based on the position of a marker located in the vicinity of the specific part.
  • the specific part range information generation unit 140 is a processing unit that generates a three-dimensional range of the specific part for each of a plurality of times.
  • the specific part representative range information generation unit 150 displays representative range information indicating a range including all the three-dimensional ranges of the specific part for each of the plurality of times when the position information of the specific part for each of the plurality of times is set as the same reference point. A processing unit to be generated.
  • the radiation dose calculation unit 160 follows the positional information of the specific part for a plurality of times, and within the specific part range indicated by the representative range information when the specific range indicated by the representative range information is irradiated with radiation for a predetermined time. It is a process part which calculates the radiation dose irradiated.
  • FIG. 5 is a functional block diagram of the specific part position calculation unit 130.
  • the specific part position calculation unit 130 includes a reference position information acquisition unit 51, a representative point reference position information calculation unit 52, a relative position information calculation unit 53, a marker position information acquisition unit 54, and a representative point position information calculation unit. 55, a specific part position information calculation unit 56.
  • the reference position information acquisition unit 51 acquires reference position information indicating the positions of the specific part 61 and the plurality of markers 62 in the patient 43 at the reference time.
  • the reference position information acquisition unit 51 acquires the reference position information from a three-dimensional CT image generated based on a transmission image captured by the radiation therapy apparatus 3.
  • the reference position information of the specific part 61 and the plurality of markers 62 is expressed as three-dimensional coordinates.
  • the representative point reference position information calculation unit 52 generates representative point reference position information indicating the positions of the representative points of the plurality of markers 62 at the reference time in the subject.
  • the representative point reference position information calculation unit 52 specifies a weighting factor for each of the plurality of markers 62.
  • the representative point reference position information calculation unit 52 calculates the reference position of the representative point by multiplying the weighting coefficient of the corresponding marker 62 by the three-dimensional coordinates indicated by the reference position information for each of the plurality of markers 62.
  • Representative point reference position information including the reference position of the point is generated.
  • the three-dimensional coordinates indicated by the reference position information for each of the plurality of markers 62 are acquired by the reference position information acquisition unit 51.
  • the position information of the weighted center of gravity of each position indicated by the reference position information of the plurality of markers 62 is the representative point reference position information.
  • the representative point reference position information is generated as three-dimensional coordinates. That is, coordinates of the n-th marker 62 (X n, Y n, Z n), when the number of markers 62 N, the weighting factors of the n-th marker 62 and W n, the reference representative point G a Reference position information (X Ga , Y Ga , Z Ga ) indicating the position can be calculated by the following formulas (1a) to (1c).
  • X Ga (X 1 W 1 + X 2 W 2 + X 3 W 3 + ⁇ + X N W N) / N ⁇ (1a)
  • Y Ga (Y 1 W 1 + Y 2 W 2 + Y 3 W 3 + ⁇ + Y N W N) / N ⁇ (1b)
  • Z Ga (Z 1 W 1 + Z 2 W 2 + Z 3 W 3 +... + Z N W N ) / N (1c)
  • the relative position information calculation unit 53 generates relative position information based on the position indicated by the representative point reference position information of the position indicated by the reference position information of the specific part 61.
  • the reference position information of the specific part 61 is acquired as three-dimensional coordinates by the reference position information acquisition unit 51, and the representative point reference position information is generated as three-dimensional coordinates by the representative point reference position information calculation unit 52. Therefore, the relative position information calculation unit 53 generates relative position information based on the difference between the three-dimensional coordinates of the position indicated by the reference position information of the specific part 61 and the three-dimensional coordinates of the position indicated by the representative point reference position.
  • the marker position information acquisition unit 54 acquires position information of the plurality of markers 62 at a time t different from the reference time after a predetermined time has elapsed from the reference time. In this process, the marker position information acquisition unit 54 uses the three-dimensional CT generated by the radiation therapy apparatus 3 to obtain the position information of the plurality of markers 62 at time t, similarly to the reference position information of the plurality of markers 62 described above. Obtain from an image. The position information of the plurality of markers 62 is expressed as three-dimensional coordinates.
  • the representative point position information calculation unit 55 generates representative point position information at time t from the position information of the plurality of markers 62 at time t different from the reference time acquired by the marker position information acquisition unit 54.
  • the representative point position information calculation unit 55 specifies a weighting factor for each of the plurality of markers 62 as in the representative point reference position information calculation unit 52.
  • the representative point position information calculation unit 55 multiplies the identified weighting factor for each of the plurality of markers 62 by the three-dimensional coordinates at the time t for each of the plurality of markers 62 to calculate the position of the representative point. Generate.
  • the three-dimensional coordinates at time t for each of the plurality of markers 62 are acquired by the marker position information acquisition unit.
  • the representative point position information calculation unit 55 generates the positions of the weighted gravity centers at the time t of the plurality of markers 62 as representative point position information.
  • This representative point position information is represented as three-dimensional coordinates.
  • Formula for calculating the position of the representative point G b is the same as the above-mentioned formula (1).
  • the specific part position information calculation unit 56 calculates the position information of the specific part 61 at time t from the representative point position information generated by the representative point position information calculation unit 55 and the relative position information generated by the relative position information calculation unit 53. Is generated.
  • the specific part position information calculation unit 56 adds the three-dimensional coordinates of the position indicated by the representative point position information at the time t and the three-dimensional coordinates of the relative position indicated by the relative position information to thereby obtain the specific part 61 at the time t. Generate location information.
  • the specific part position information calculation unit 56 transmits the calculated position information of the specific part 61 at time t to the radiotherapy apparatus control apparatus 2. And the radiotherapy apparatus control apparatus 2 controls the radiotherapy apparatus 3 based on the position information. As a result, the radiation therapy apparatus 3 controls the swing mechanism 15 so that the therapeutic radiation 23 irradiates the position indicated by the position information calculated by the specific part position information calculation unit 56 based on the control of the radiation therapy apparatus control apparatus 2. Is used to drive the therapeutic radiation irradiation device 16, and the MLC 20 is used to control the shape of the irradiation field of the therapeutic radiation 23.
  • the radiotherapy device control apparatus 2 controls the emission of the therapeutic radiation 23 using the therapeutic radiation irradiation device 16 of the radiotherapy device 3 after controlling the driving of the swing mechanism 15 and the MLC 20.
  • the radiotherapy device controller 2 controls the turning drive device 11 or the travel drive device or the couch drive device 42 of the radiotherapy device 3 so that the therapeutic radiation 23 irradiates the position of the specific part 61, and the patient
  • the positional relationship between 43 and the therapeutic radiation irradiation device 16 can also be changed.
  • FIG. 6 is a diagram illustrating a processing flow of the treatment planning apparatus 1.
  • the treatment planning apparatus 1 stores a CT image of the subject at each of a plurality of times t corresponding to the passage of time in the storage unit 170.
  • the CT image is data generated from a transmission image of the subject imaged by the radiation therapy apparatus 1.
  • the specific part position calculation unit 130 of the treatment planning apparatus 1 reads CT images of the subject for a plurality of times from the storage unit 170 (step S101).
  • the specific part position calculation unit 130 detects the positions of the plurality of markers 62 located in the vicinity of the specific part 61 from the CT image, and calculates the position information of the specific part 61 based on the positions of the plurality of markers 62. Similarly, the specific part position calculation unit 130 calculates the position information of the specific part 61 at each time by using CT images at other times. Thereby, the specific part position calculation part 130 calculates the positional information of the specific part 61 about several time according to progress of time (step S102). The position of the marker 62 and the position of the specific part 61 are represented by three-dimensional coordinates.
  • FIG. 7 is a first diagram illustrating a flowchart of the process of the specific part position calculation unit 130.
  • the specific part position calculation unit 130 inputs three-dimensional coordinates as reference position information of the specific part 61 and the plurality of markers 62 based on the three-dimensional CT image read from the storage unit 170 (step S701).
  • the three-dimensional coordinates of the reference position information of the plurality of markers 62 may be input from the three-dimensional CT image displayed on the screen based on the coordinates designated by the doctor using an input means such as a mouse.
  • a processing unit that detects luminance from the luminance values of a plurality of markers in the CT image and automatically calculates coordinates from the luminance may be provided and input from the processing unit.
  • the three-dimensional coordinates of the position information of the specific part 61 may be input from a three-dimensional CT image displayed on the screen based on coordinates designated by a doctor using an input means such as a mouse.
  • the three-dimensional coordinates of the position information of the specific part 61 are automatically obtained by using an image of the specific part 61 stored in advance and performing image processing such as pattern matching on the image of the specific part in the three-dimensional CT image matching the image.
  • coordinates such as the center of the range of the specific part may be input as position information of the specific part 61.
  • the specific part position calculation unit 130 generates the representative point reference position information of the plurality of markers 62 at the reference time from the three-dimensional coordinates indicating the reference position information of the plurality of markers 62 acquired in step S701 (step S702).
  • the representative point reference position information is expressed as three-dimensional coordinates. Specific generation processing will be described later.
  • the specific part position calculation unit 130 generates relative position information of the position indicated by the reference position information of the specific part 61 with the representative point reference position as a base point (step S703). Specifically, the difference between the three-dimensional coordinates of the position indicated by the representative point reference position and the three-dimensional coordinates of the position indicated by the reference position information of the specific part 61 is obtained.
  • the specific part position calculation unit 130 obtains position information of the plurality of markers 62 from a three-dimensional CT image generated from a transmission image captured at a time t different from the reference time, similarly to step S701. Input (step S704). Then, the specific part position calculation unit 130 generates representative point position information of the plurality of markers 62 at time t from the position information of the plurality of markers 62 (step S705).
  • the position information of the plurality of markers 62 is expressed as three-dimensional coordinates. Specific generation processing of representative point position information of the plurality of markers 62 will be described later.
  • the specific part position calculation unit 130 calculates the position of the specific part 61 at time t from the relative position information indicating the relative position calculated in step S703 and the representative point position information indicating the position of the representative point at time t calculated in step S705. Information is calculated (step S706). Specifically, the position indicated by the three-dimensional coordinates obtained by adding the three-dimensional coordinates of the position indicated by the relative position information to the three-dimensional coordinates of the position indicated by the position information of the representative point is calculated as the position information of the specific part 61.
  • the specific part position calculation unit 130 acquires the position information of the specific part 61 in this way, and determines whether the position information of the specific part 61 has been calculated from the three-dimensional CT images generated for all times. When the specific part position calculation unit 130 has not calculated the position information of the specific part 61 from the three-dimensional CT images generated for all times, the specific part position calculation unit 130 proceeds to the process of step S704 and proceeds to the next time. The CT image of t is input and the calculation process of the position information of the same specific part 61 is repeated. In addition, when the position information of the specific part 61 is calculated from the three-dimensional CT images generated for all times, the specific part position calculation unit 130 calculates the position information of the specific part 61 calculated for each time t. The information is recorded in the storage unit 170, and the control unit 110 is notified of the end of processing.
  • FIG. 8 is a second diagram illustrating a flowchart of the process of the specific part position calculation unit 130.
  • the representative point reference position information calculation unit 52 of the specific part position calculation unit 130 calculates reference position information of the representative point at the reference time, as shown in FIG.
  • the representative point reference position information calculation unit 52 specifies a weighting factor for each of the plurality of markers 62 (step S801). This weighting coefficient is specified in three dimensions, as is the position information of the marker 62. That is, the weighting factor W is represented in the form of (W x , W y , W z ).
  • the representative point reference position information calculation unit 52 multiplies the identified weight coefficient by the three-dimensional coordinates of the position indicated by the position information of the corresponding marker 62 (step S802).
  • the representative point reference position information calculation unit 52 generates position information of the representative point based on the three-dimensional coordinates of the position indicated by the position information for each of the plurality of markers 62 multiplied by the weighting coefficient thus calculated (step S803). ).
  • the calculation formula is the same as the above formula (1).
  • the representative point reference position information calculation unit 52 uses the position information at the reference time of the representative points of the plurality of markers 62 thus obtained as the representative point reference position information for the plurality of markers 62 to the relative position information calculation unit 53. Output.
  • the representative point reference position information calculation unit 52 calculates the reciprocal of the distance between the specific part 61 and the plurality of markers 62 for each of the plurality of markers 62 and uses it as a weighting factor for each of the plurality of markers 62. Identify.
  • the representative point reference position information calculation unit 52 indicates the distance between the specific part 61 and the plurality of markers 62, the three-dimensional coordinates of the position indicated by the reference position information of the specific part 61 at the reference time, and the reference of the plurality of markers 62 at the reference time. The absolute value of the difference from the three-dimensional coordinates of the position indicated by the position information is obtained.
  • FIG. 9 is a third diagram illustrating a flowchart of the process of the specific part position calculation unit 130.
  • the representative point position information calculation unit 55 of the specific part position calculation unit 130 generates position information of the representative point at time t as shown in FIG.
  • the representative point position information calculation unit 55 specifies a weighting factor for each of the plurality of markers 62 (step S901). This weighting coefficient is specified in three dimensions, as is the position information of the marker 62. That is, the weighting factor W is represented in the form of (W x , W y , W z ).
  • the representative point position information calculation unit 55 multiplies the identified weight coefficient by the three-dimensional coordinates of the position indicated by the position information of the corresponding marker 62 (step S902).
  • the representative point position information calculation unit 55 generates position information of the representative point based on the three-dimensional coordinates of the position indicated by the position information for each of the plurality of markers 62 multiplied by the weighting coefficient thus calculated (step S903).
  • the calculation formula is the same as the above formula (1).
  • the representative point position information calculation unit 55 calculates the reciprocal of the distance between the specific part 61 and the plurality of markers 62 for each of the plurality of markers 62 and specifies it as a weighting factor for each of the plurality of markers 62. To do. Further, the representative point position information calculation unit 55 obtains the weighting coefficient at time t from the distance between the specific part 61 and the plurality of markers 62 at the reference time. That is, the representative point position information calculation unit 55 indicates the distance between the specific part 61 and the plurality of markers 62 at the reference time, the three-dimensional coordinates of the position indicated by the position information of the specific part 61 at the reference time, and the plurality of markers at the reference time. The absolute value of the difference from the three-dimensional coordinates of the position indicated by the position information 62 is obtained.
  • the treatment planning device 1 obtains a representative point from the position information of the plurality of markers 62 multiplied by the weighting coefficient corresponding to the distance from the specific part 61 by the specific part position calculation unit 130. Can do. Therefore, the weighting coefficient of the marker 62 existing at a position away from the specific part 61 is low, and the weighting coefficient of the marker 62 existing near the specific part 61 is high.
  • the marker 62 present at a position away from the specific part 61 differs from the specific part 61 in the amount of displacement and the direction of displacement, and the marker 62 present at a position close to the specific part 61 is different from the specific part 61 in the amount of displacement and the direction of displacement. It is considered similar.
  • the representative point can be calculated by increasing the weight of the marker 62 whose displacement state is similar to that of the specific part 61, the displacement state of the representative point can be brought close to the displacement state of the specific part 61. Thereby, the accuracy of the position detection of the specific part 61 can be improved.
  • the position information of such a specific part it becomes possible to detect the position of the specific part with sufficient accuracy for tracking irradiation in the radiotherapy apparatus, and treatment is performed on a normal part other than the specific part of the patient. It is possible to prevent excessive radiation from being applied.
  • a correlation parameter between the displacement amount of the specific part 61 from the reference position at a plurality of different times and the displacement amount of the marker 62 from the reference position is used. May be.
  • the correlation parameter is a parameter representing a correlation between the displacement amount from the reference position of the specific part 61 and the displacement amount from the reference position of the marker 62, and may be calculated as a correlation coefficient.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 of the specific part position calculation unit 130 obtain the position indicated by the position information of the specific part 61 at a plurality of different times, The amount of displacement from is obtained.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 of the specific part position calculation unit 130 are the position information of the marker 62 at a plurality of different times when the position of the specific part 61 is obtained. Is obtained, and the amount of displacement from the reference position is obtained.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 of the specific part position calculation unit 130 calculate the displacement amount from the reference position of the specific part 61 thus obtained and the displacement amount from the reference position for each marker 62.
  • the correlation coefficient indicates that there is no correlation between the two variables as it approaches 0, and there is a high correlation between the two variables as it approaches 1.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 specify the correlation coefficient thus calculated as a correlation parameter and use it as a weighting coefficient.
  • FIG. 10 is a diagram for explaining an example of a relative parameter calculation method, in which a displacement amount from a reference position of a specific part at a plurality of times and a displacement amount from a reference position of a marker at a plurality of times. It is a figure which shows the relationship.
  • the correlation parameter may be calculated based on the amount of displacement from the reference position of the specific part 61 at a plurality of different times, and this may be used as a weighting coefficient.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 of the specific part position calculation unit 130 are based on the reference position of the specific part 61 at a plurality of different times.
  • a displacement amount and a displacement amount from a reference position of a certain marker 62 at a plurality of different times are calculated.
  • a t represents the displacement from the reference position of the specific portion 61 at time t, the relationship between the amount of displacement from the reference position of one certain marker 62a.
  • a t1 represents a correspondence relationship between the displacement amount (x 1 ) from the reference position of the specific part 61 and the displacement amount (y 1 ) from the reference position of the marker 62a at time t 1 .
  • Representative point reference position information computation unit 52 and the representative point position information calculation section 55 of the specific portion position calculating unit 130, a plurality of A t (x, y) to calculate the distance between the straight line expressed by the y x, It carries out about the marker 62a, and calculates the total value. And the reciprocal number of the said sum total value is specified as a correlation parameter, and is specified with the weighting coefficient about the said marker 62a. The same weighting factor is similarly specified for the markers 62 other than the marker 62a.
  • FIG. 11 is a diagram illustrating a correspondence relationship between the displacement amount from the reference position of the specific part and the displacement amount from the reference position of the marker.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 have a 45 ° slope composed of a set of plots in which the displacement amount from the reference position of the specific part 61 and the displacement amount from the reference position of the marker 62 are equal.
  • the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 specify the reciprocal of the sum as a weighting coefficient to be applied to the marker 62a. Similarly, the representative point reference position information calculation unit 52 and the representative point position information calculation unit 55 specify weight coefficients for other markers.
  • a representative point can be obtained by multiplying the marker 62 showing a high correlation with the specific part 61 by a high weighting coefficient. Therefore, the state of displacement of the representative point can be brought close to the state of displacement of the specific part 61, and the accuracy of position detection of the specific part 61 can be improved.
  • the displacement state is different even when the marker 62 is present near the specific part 61, for example, when the marker 62 exists near the heart of the subject and is greatly affected by the pulsation of the heart, etc.
  • the position of the specific part 61 can be detected with high accuracy.
  • weighting factor may be specified by being arbitrarily input by the user by the input means.
  • the weighting factors of the plurality of markers 62 can be arbitrarily specified by the user's judgment. Therefore, the position of the specific part 61 using the representative points weighted for each of the plurality of markers 62 can be detected more simply.
  • the weighting factor of at least one marker 62 among the plurality of markers 62 may be specified as 0.
  • the marker 62 used for calculation of position detection of the specific part 61 may be arbitrarily selected.
  • the calculation process of the position information of the specific part 61 described above is an operation using the center of gravity, but instead, the position information of the specific part 61 may be calculated using the distance between the marker 62 and the specific part 61. Good.
  • the calculation process of the position information of the specific part 61 by the method is as follows. (1) The positions of the specific part 61 and each marker 62 at the reference time are acquired. (2) The position of each marker 62 at another time is acquired. (3) Based on the distance between the position of each marker 62 and the position of the specific part at another time, and the distance between the position of each marker 62 and the position of the specific part at the reference time, the reference time of the distance at another time Evaluate variation from distance in. (4) As the position information of the specific part at a certain time, the position information of the specific part with the smallest distance variation error is calculated by the least square method.
  • the control unit 110 notifies the specific part range information generation unit 140 of the start of the process. Then, the specific part range information generation unit 140 generates a three-dimensional range (CTV; Critical Tumor Volume) of the specific part for each of a plurality of times (step S103). More specifically, the specific part range information generation unit 140 first displays the CT image at the time t1 read from the storage unit 170 on the screen.
  • the CT image is composed of a plurality of images of successive cross sections of the subject. In a plurality of cross-sectional images of the subject indicated by the CT image displayed at time t1 displayed on the screen, a user such as a doctor makes an entry surrounding the range of the specific part.
  • the entered information is detected by an input sensor such as a touch panel constituting the screen and output to the treatment planning apparatus 1.
  • the specific part range information generation part 140 inputs the range information of the specific part in each cross section indicated by the CT image at time t1, and generates information on the three-dimensional range of the specific part based on the information.
  • the specific part range information generation unit 140 may generate information on the three-dimensional range of the specific part by pattern matching or the like based on information on the image of the specific part stored in advance.
  • the specific part range information generation unit 140 determines whether the three-dimensional range information has been generated for all CT images at time t. If the three-dimensional range information is not generated for all CT images at time t, the next CT image at time t is read from the storage unit 170, and similarly, a plurality of images of each cross section of the CT image are read. Is output to the screen. Thereby, the specific part range information generation unit 140 repeats generation of three-dimensional range information for all CT images at time t. When the specific part range information generation unit 140 generates the three-dimensional range information for all CT images at time t stored in the storage unit 170, the specific part range information generation unit 140 notifies the control unit 110 of the end of the process.
  • the control unit 110 instructs the specific part representative range information generation unit 150 to start processing.
  • the specific part representative range information generation unit 150 includes a range that includes all of the three-dimensional ranges of the specific part for each of the plurality of times t when the position information of the specific part for each of the plurality of times t is the same reference point.
  • the representative range information shown is generated (step S104). More specifically, the specific part representative range information generation unit 150 reads from the storage unit 170 the position information (three-dimensional coordinates) of the specific part at each time t and the information of the three-dimensional range of the specific part at each time t. . Then, the specific part representative range information generation unit 150 matches the position information of the specific part at each time t as the same reference point, and generates representative range information indicating a range including all the three-dimensional ranges in that case.
  • FIG. 12 is a diagram showing an outline of processing of the specific part representative range information generation unit 150.
  • 3D range information about (a) the time t 1 CT image in FIG, (b) three-dimensional range information about the CT image of time t 2, the for (c) the time t 3 CT image 3 dimensional range information indicates a 3-dimensional range information (d) are time t 4 CT images.
  • the three-dimensional range information (a) to (d) may include three-dimensional position information of the specific part at each time t. Since the specific part moves within the subject with the passage of time and the range thereof is deformed, each of the three-dimensional range information (a) to (d) includes three-dimensional information indicating different position information and ranges. It shows information such as coordinates.
  • the specific part representative range information generation unit 150 matches the position information of the specific part at each time t as the same reference point, and includes all the three-dimensional ranges in that case.
  • Representative range information indicating the range is generated.
  • the range of the outermost thick line in (e) of FIG. 12 is a range indicating the representative range information.
  • the specific part representative range information generation unit 150 records the generated representative range information in the storage unit 170 and notifies the control unit 110 of the end of the process.
  • the range of the specific part is shown in two dimensions, but it is actually information indicating the three-dimensional range.
  • the control unit 110 instructs the radiation dose calculation unit 160 to start processing.
  • the radiation dose calculation unit 160 acquires the representative range information of the specific part recorded in the storage unit 170.
  • the radiation dose calculation unit 160 calculates the radiation dose when the specific part indicated by the representative range information is irradiated with tracking radiation (step S105).
  • the radiation dose calculation unit 160 calculates the radiation dose using the intensity of irradiation radiation, the irradiation time, the position of the radiation source, representative range information, and the like. Good.
  • the radiation dose calculation unit 160 may calculate the irradiation time until reaching the upper limit of the radiation dose that can be irradiated to the specific part using a known technique.
  • a user such as a doctor may input information such as the position of the radiation source into the treatment planning apparatus 1.
  • a user such as a doctor uses the calculated radiation dose to make a treatment plan such as the position of the radiation source and the irradiation time.
  • the treatment planning device outputs the above-described representative range information to the radiation treatment device control device 2.
  • the radiation therapy apparatus control device 2 outputs the representative range information to the therapeutic radiation irradiation apparatus 16.
  • the therapeutic radiation irradiation device 16 controls the shape of the MLC 20 based on the representative range information. That is, the MLC 20 shields a part of the therapeutic radiation 23 and changes the shape of the irradiation field when the therapeutic radiation 23 is irradiated to the patient.
  • Each process of the treatment planning apparatus 1 described above may be performed by the radiation therapy apparatus control apparatus 2 including the same processing units as the treatment planning apparatus 1, or similar to the treatment planning apparatus 1. It may be performed by the radiation therapy apparatus 3 provided with each processing unit.
  • Each of the above devices has a computer system inside.
  • Each process described above is stored in a computer-readable recording medium in the form of a program, and the above process is performed by the computer reading and executing the program.
  • the computer-readable recording medium means a magnetic disk, a magneto-optical disk, a CD-ROM, a DVD-ROM, a semiconductor memory, or the like.
  • the computer program may be distributed to the computer via a communication line, and the computer that has received the distribution may execute the program.
  • the program may be for realizing a part of the functions described above. Furthermore, what can implement
  • a treatment planning apparatus capable of measuring the radiation dose of a specific part that moves and changes in range within a subject with time with higher accuracy.

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  • Biomedical Technology (AREA)
  • Pathology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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PCT/JP2013/055076 2012-02-28 2013-02-27 治療計画装置及び治療計画方法並びにそのプログラム WO2013129450A1 (ja)

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US14/379,906 US9393444B2 (en) 2012-02-28 2013-02-27 Treatment planning device, treatment planning method, and program therefor
CN201380010659.9A CN104136080B (zh) 2012-02-28 2013-02-27 治疗计划装置和治疗计划方法
EP13754047.2A EP2821100B1 (de) 2012-02-28 2013-02-27 Behandlungsplanungsvorrichtung, behandlungsplanungsverfahren und programm dafür

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JP6139361B2 (ja) 2013-09-30 2017-05-31 株式会社東芝 医用画像処理装置、治療システム及び医用画像処理方法
JP6815587B2 (ja) * 2016-01-06 2021-01-20 東芝エネルギーシステムズ株式会社 治療システム、医用画像処理装置、および治療プログラム
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JP5916434B2 (ja) 2016-05-11
EP2821100B1 (de) 2017-02-08
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